The present invention concerns in general an improved halo system and method, and in particular concerns an improved adjustable, two poster halo system orthopedic appliance and corresponding methodology.
The treatment of orthopedic patients includes use of so-called halo-vest systems, in which a ring or halo is secured with skull pins or the like to the skull of a patient and thereafter rigidly aligned in relation to the patient's skeletal system. In general, the halo is variously interconnected to some other structure worn by the patient, such as a vest.
The general principles of operation of the halo-vest system in the treatment of injuries to the cervical spine are well known. For example, such prior art systems are frequently used to introduce a degree of traction to the cervical spine of a patient. The cervical spine is stabilized in a selected position by fixing of the skull in reference to the chest through use of some exterior mechanical apparatus. The above-mentioned traction is achieved through use of the various mechanisms interconnecting the halo and the vest. Soft tissue stresses are generally low because forces involved are spread over the chest area by the mechanical unit.
Since introduction of the halo principle generally related to orthopedic surgery during the 1950s, various systems have been provided. For example, the present assignee, Friddle Orthopedic Appliances of Honea Path, S.C., has marketed a halo system which interconnects a halo ring and halo vest with four upright turnbuckles. The base of the four turnbuckles interconnect with screws to superstructure supported on a vest. The upper ends of the four turnbuckles interconnect through screws to a pair of generally horizontal bars which in turn are connected at an upward extension thereof to the halo ring. While such a four turnbuckle design allows for infinite adjustment and provides excellent stability, a finite amount of time is required for making such adjustments, and a finite amount of space is required for the four separate turnbuckles. A serration system is also provided in connection with anterior-posterior deflection superstructure adjustment. Such further adjustability permits additional flexibility in use and adjustment of the appliance, but requires the additional time and effort to do so. Also, the adjustability of a turnbuckle system is finite.
Bremer Medical Companies, Inc., of Jacksonville, FL, markets a halo system which provides four upright posts at widely separated positions supporting a pair of transverse bars which carry respective halo clamps. Overall adjustability is limited, particularly at the base of the posts, which have curved and angled portions. Likewise, plural adjustments are necessary in order to effect changes in traction, for example, to equally raise the halo relative all four upright posts.
Various advantages and disadvantages of available systems and materials have been discussed in the literature. For example, the above-referenced Bremer Medical Companies, Inc., has an MRI compatible version of its halo system which has been the subject of a study report entitled "Compatibility of Cervical Spine Braces with MR Imaging" by Clayman the American Society of Neuroradiology. Such study also reports on a four poster design by PMT Corporation of Chanhassen, Minnesota, which uses components interconnected with plastic ball and socket joints, and which require securement of plural screws to immobilize each of the respective ball and socket joints.
Some prior systems make use of an arrangement of two upright members. For example, one halo system by Durr-Fillauer includes two turnbuckles secured by bolts at their respective ends to a halo ring and to superstructure carried on a vest. Again, the adjustability of turnbuckles is limited, and separate operations must be made in order to adjust a given turnbuckle per se verses its interconnection and relationship to either the superstructure or the halo ring. Kronner Inc. of Roseburg, OR, markets a product having two uprights. The upper end of each upright is threaded, with a traveling clamp captured along such threaded portion at a desired point by a respective pair of upper and lower jam nuts. The upper traveling members of the Kronner product each interconnect with another support member which then directly connects to the halo ring. Each lower end of an upright is secured by respective lower clamps also requiring each two bolts for adjustment and securement.
In the foregoing two upright devices, there can be a question of adequate stability and strength of the traction and alignment of the cervical spine of the patient, added with the complexity and time factor of effecting application and adjustment of the appliance.
Friddle et. al. (U.S. Pat. No. 4,738,252), commonly assigned with the subject application, relates to a mechanical joint construction in which a number of elements (shown in exploded view in FIG. 2 thereof) are assembled with a fastening bolt 56, which may be used to change or relocate the position of limited pivotable movement of the orthosis 10. One of the inventors of the '252 patent has another U.S. Pat. No. 4,648,390, entitled LOW PROFILE NECK RING ORTHOSIS, which is another example of a prior device which may be used as an attachment for supporting structure of an orthopedic body brace employed to treat curvature of the spine.